TAILIEUCHUNG - Chapter 126. Infections in Transplant Recipients (Part 17)

Tham khảo tài liệu 'chapter 126. infections in transplant recipients (part 17)', y tế - sức khoẻ, y học thường thức phục vụ nhu cầu học tập, nghiên cứu và làm việc hiệu quả | Chapter 126. Infections in Transplant Recipients Part 17 Table 125-3 Controlling Antibiotic Resistance Approaches to Consider Conduct surveillance for antibiotic resistance. Perform molecular typing . pulsed-field gel electrophoresis when rates increase. For clonal expansion . single-strain outbreaks Stress hand hygiene alcohol hand rub and universal gloving monitor adherence and give feedback. For polyclonal expansion . multistrain outbreaks Stress antibiotic prudence consider antibiotic rotation for ICUs monitor adherence and give feedback. For continued problems Obtain patient-surveillance cultures and isolate or provide cohort nursing for colonized infected patients. Control device-related infections. Enlist administrative support proactively. Source Adapted from RA Weinstein Emerg Infect Dis 7 188 2001 see also www. cdc. gov ncidod dhqp pdf ar . Currently several antibiotic resistance problems are of particular health care concern. First the emergence of community-acquired MRSA has been dramatic in many countries with as many as 50 of community-acquired staph infections in some . cities now caused by strains resistant to 0-lactam antibiotics Chap. 129 . The potential incursion of these strains into hospitals and the resulting impact on control of nosocomial MRSA infections are of enormous concern. Second in the ongoing global reemergence of nosocomial multidrug resistant gram-negative bacilli new problems include plasmid-mediated resistance to fluoroquinolones metallo-0-lactamase-mediated resistance to carbapenems and panresistant strains of Acinetobacter. Many of these multidrug-resistant strains are susceptible only to colistin which has led to a rediscovery and renewed use of this drug. Finally clinical infections with MRSA strains exhibiting high-level vancomycin resistance due to VRE-derived plasmids have been reported in several patients in the United States often in the setting of prolonged or repeated treatment with .

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• Infections in Transplant Recipients
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• Infections in kidney transplant recipients
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